Audits and Coding Quality Reviews
The implementation and operation of this program is quite simple. Periodically (monthly, quarterly, semi-annually, or annually) participating practices send us a representative sample of their visit notes, procedure reports and claim forms. We perform a government-style audit of the coding, using all available screens and regulations. We then send you a case-by-case analysis of our findings. Our medical coding and surgical coding accuracy evaluations are designed to be part of a continuous quality improvement program. It gives our clients’ medical coders and surgical coders the feedback they need to more accurately code the patient-care services.
Have you been the target of a compliance audit? If you think you’re being treated unfairly, let us “audit the auditors.” Our findings can be your best defense!
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Fredericksburg Hospitalist Group, located in Richmond, VA, and fourteen of its member shareholders have agreed to pay nearly $4.2 million to settle a federal FCA case brought under the “qui tam whistleblower” provisions. Dana J. Boente, […]
Medicare Advantage Organization and Former COO to Pay $32.5 Million to Settle False Claims Act Allegations
Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively “Freedom Health”), agreed to pay $31,695,593 to resolve allegations that they violated the False Claims Act by engaging […]
New York City: According to a recent OIG report, Mount Sinai Hospital failed to comply with Medicare’s billing requirements for 110 outpatient and inpatient claims reviewed by the office of Inspector General for the audit […]